Smart implants making a difference for patients

Excerpted from "CyborgRx: How Smart Implants Could Change Medicine," NBC News. February 17, 2015 — The cyborgs are coming ... and that's a good thing. A new breed of smart devices designed to be implanted in the brain, heart and other body parts could be used to treat everything from epilepsy to Parkinson's disease. They're already helping people like Chelsey Loeb. The 26-year-old can't feel the responsive neurostimulator (RNS System for short) firing electrical pulses into her brain. It's about the size of an iPod Nano and is constantly monitoring electrical activity from under her skull, looking for signs of a seizure so it can send out a targeted pulse to cut one off before it begins.

Designed by Silicon Valley-based NeuroPace, the RNS System is on the frontier of this new technology. But there are hopes that devices implanted under the skin could one day do things like automatically regulate glucose levels in diabetics or tell someone when their knee is about to give out. Right now, smart implants are giving hope to epilepsy patients like Loeb. Across the nation, 128 of them have been installed since the FDA approved the device in 2013. Clinical trials showed a 38 percent drop in the average number of seizures per month.

DARPA, the research arm of the U.S. Department of Defense, is also looking into smart implants. In August 2014, it announced the Electrical Prescriptions (ElectRx) program, which encourages the development of "ultraminiaturized devices" the size of nerve fibers that would "continually assess conditions and provide stimulus patterns tailored to help maintain healthy organ function."

Researchers are also starting to think about how multiple smart devices might work together. The EU-funded WISERBAN is a project aimed at creating a 'wireless body-area network' (WBAN) that would let smart implants communicate wirelessly with each other and the outside world without draining their limited power resources.

Commentary

CMDA Ethics Committee Chair and Academic Neurologist William P. Cheshire, MD, MA: “As physicians, we have become doctors of cyborgs, and that's a good thing, provided we meet the ethical challenges. The wise application of sophisticated technology always requires proportionately thoughtful ethical analysis to enable appropriate use, prevent inappropriate use and limit unintended harmful consequences.

“Talk of cyborgs conjures up fantastic science fiction images of men and women whose bodies have been taken over by powerful runaway technologies threatening to supersede our humanity. The present reality, by contrast, is that technology is being used to rescue patients. Nearly all physicians in the developed world care for patients who have been implanted with artificial joints or pacemakers. A smaller but growing number of patients are living healthier lives with implanted cardiac monitors, nerve or brain stimulators, cochlear implants and programmable catheters. These and other biomedical electronic devices are to be welcomed for their therapeutic potential to bring healing and restoration to patients with disease and disability.

“Cyborg biomedical technologies also touch on profound questions about what it means to be human and what it might mean to be a redesigned human. Futurist Ray Kurzweil predicts, ‘We're going to become increasingly non-biological to the point where the non-biological part dominates and the biological part is not important any more.’ Taken to the extreme, the philosophy of transhumanism looks to the day when the human organism will be radically redesigned, if not inevitably replaced, by synthetic, artificial intelligences.

“Aside from the practical question of whether radical re-engineering of the human species is technically possible is the more immediate concern—if we were to become too enamored by technological bodily enhancements, how would we then regard our biological neighbors? We know one another not as amalgams of flesh and silicon but as embodied persons bearing the image of God. Would we value people less if we believed that bodily parts were easily replaceable or that minds could be uploaded to computers? Would remaking humanity in our own image cause us to lose sight of the face of Christ in those who suffer?

“Chelsey Loeb's story reminds us that each and every one of us is unique and special. ‘It's like a big puzzle,’ she says, ‘because my brain is unlike any other.’ Chelsey's experience is yet another example of how advances in neuroscience and biotechnology do not lead to a cold, mundane, materialistic understanding of humanity. Rather, through science we discover new levels at which human life is a great mystery.”

Resources

CMDA’s Eugenics and Enhancement Ethics Statement
Till We Have Minds by Dr. William Cheshire
Why Human Bioenhancement Technologies Are a Bad Idea